Individual
MS. BETHANIE DINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1050 OLD DES PERES RD, SUITE 100, SAINT LOUIS, MO 63131-1873
(314) 569-0612
(314) 966-0664
Mailing address
1050 OLD DES PERES RD, SUITE 100, SAINT LOUIS, MO 63131-1873
(314) 569-0612
(314) 966-0664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005013485
MO
Other
Enumeration date
04/26/2007
Last updated
03/23/2021
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