Provider Demographics
NPI:1326653015
Name:BUJOLD, FRANCIS X II (MT,JD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:X
Last Name:BUJOLD
Suffix:II
Gender:M
Credentials:MT,JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1734
Mailing Address - Country:US
Mailing Address - Phone:248-979-7665
Mailing Address - Fax:
Practice Address - Street 1:335 DOUGLAS DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-1734
Practice Address - Country:US
Practice Address - Phone:248-979-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501008325225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist