Organization
INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC
Active
Other names
Midwest Proton Radiotherapy Institute, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KERSTIENS CPA (COO/CFO)
(812) 349-5028
Entity
Organization
Contact information
Practice address
2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
(812) 349-5074
(812) 349-5046
Mailing address
2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
(812) 349-5074
(812) 349-5046
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
NA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200442910A
—
IN
Enumeration date
09/28/2006
Last updated
11/28/2012
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