Healthcare Provider Details

I. General information

NPI: 1194648295
Provider Name (Legal Business Name): TWO TREES OSTEOPATHIC MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SEMINOLE RD STE 207
NORTON SHORES MI
49444-3762
US

IV. Provider business mailing address

433 SEMINOLE RD STE 207
NORTON SHORES MI
49444-3762
US

V. Phone/Fax

Practice location:
  • Phone: 231-559-0300
  • Fax: 231-252-1255
Mailing address:
  • Phone: 231-559-0300
  • Fax: 231-252-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONOVAN JEFFCOAT
Title or Position: OWNER
Credential: DO
Phone: 231-559-0300