# WILLOW BEND SURGICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043884604
- **Authorized official:** MATTHEW PAUL WOOD DC (PRESIDENT)
- **Authorized official phone:** (801) 450-6940

## Contact information

- **Practice address:** 650 E 4500 S STE 100, SALT LAKE CITY, UT 84107-4536
- **Practice address phone:** (801) 450-6940
- **Practice address fax:** (801) 944-5910
- **Mailing address:** 1809 E INDIAN WELLS LN, DRAPER, UT 84020-8301
- **Mailing address phone:** (801) 450-6940
- **Mailing address fax:** (801) 944-5910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2021
- **Last updated:** 05/18/2021