# IDEAL STRUCTURAL THERAPY

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

## Provider details

- **NPI number:** 1538718440
- **Authorized official:** DR. GLEN R BURFORD DC (DOCTOR OF CHIROPRACTIC)
- **Authorized official phone:** (901) 853-1734

## Contact information

- **Practice address:** 346 NEW BYHALIA RD STE 3, COLLIERVILLE, TN 38017-3741
- **Practice address phone:** (901) 853-1734
- **Practice address fax:** (901) 854-1166
- **Mailing address:** 346 NEW BYHALIA RD STE 3, COLLIERVILLE, TN 38017-3741
- **Mailing address phone:** (901) 853-1734
- **Mailing address fax:** (901) 854-1166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2019
- **Last updated:** 09/04/2019