Organization
MIKE KELO PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN KELO PT (OWNER/PHYSICAL THERAPIST)
(804) 366-8518
Entity
Organization
Contact information
Practice address
12212 BRANDERS CREEK DR, CHESTER, VA 23831-1626
(804) 425-4545
(804) 778-4522
Mailing address
12212 BRANDERS CREEK DR, CHESTER, VA 23831-1626
(804) 425-4545
(804) 425-4546
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
2305002847
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
STF191889
—
VA
Enumeration date
09/18/2008
Last updated
03/02/2023
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