# LORDEX SPINE CENTER OF COLUMBIA P.C.

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

## Provider details

- **NPI number:** 1992884217
- **Authorized official:** DR. BROOKS M TRAVIS D.C. (OWNER)
- **Authorized official phone:** (573) 443-0551

## Contact information

- **Practice address:** 3400 BUTTONWOOD DR, STE C, COLUMBIA, MO 65201-3720
- **Practice address phone:** (573) 443-0551
- **Practice address fax:** (573) 442-2959
- **Mailing address:** 3400 BUTTONWOOD DR, STE C, COLUMBIA, MO 65201-3720
- **Mailing address phone:** (573) 443-0551
- **Mailing address fax:** (573) 442-2959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | 2002023835 | MO | — |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | R8620 | MO | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 08/17/2009