Individual
DR. BETHANY T ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1 CHILDRENS PL, STE 3110, SAINT LOUIS, MO 63110-1002
(314) 454-6026
(866) 936-4559
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6026
(866) 936-4559
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2018014542
MO
152WP0200X
Pediatric Optometrist
2018014542
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310054310
—
MO
Enumeration date
05/22/2018
Last updated
04/17/2025
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