Provider Demographics
NPI:1245072453
Name:MUYENZI, LEVIS
Entity type:Individual
Prefix:
First Name:LEVIS
Middle Name:
Last Name:MUYENZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 W CREEK WAY APT 4
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3937
Mailing Address - Country:US
Mailing Address - Phone:502-424-2281
Mailing Address - Fax:
Practice Address - Street 1:1717 W CREEK WAY APT 4
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242-3937
Practice Address - Country:US
Practice Address - Phone:502-424-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company