Organization
LIFESPAN FAMILY MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA PASTORE FNP-BC (OWNER)
(970) 484-9533
Entity
Organization
Contact information
Practice address
320 W OLIVE ST, FORT COLLINS, CO 80521-2716
(970) 484-9533
(970) 484-9544
Mailing address
320 W OLIVE ST, FORT COLLINS, CO 80521-2716
(970) 484-9533
(970) 484-9544
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
105668
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68270348
—
CO
Enumeration date
11/07/2006
Last updated
01/22/2010
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