# MIKE KELO PHYSICAL THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346499928
- **Authorized official:** MR. MICHAEL JOHN KELO PT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (804) 366-8518

## Contact information

- **Practice address:** 12212 BRANDERS CREEK DR, CHESTER, VA 23831-1626
- **Practice address phone:** (804) 425-4545
- **Practice address fax:** (804) 778-4522
- **Mailing address:** 12212 BRANDERS CREEK DR, CHESTER, VA 23831-1626
- **Mailing address phone:** (804) 425-4545
- **Mailing address fax:** (804) 425-4546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | 2305002847 | VA | — |

## Other

- **Enumeration date:** 09/18/2008
- **Last updated:** 03/02/2023