Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Trung Tin Phan

Individual provider Physical Therapist · NPI 1093446221

Trung Tin Phan is a Physical Therapist in Private Practice in Suwanee, Georgia. Graduated from Emory University School of Medicine in 2022, 4 years ago. Practices with Kime Performance Nevada LLC, a 6-clinician group. Licensed in Georgia.

Years since qualifying
4
Trained at
Emory University School of Medicine
Licensed in
GA
In the registry since
2022
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Practice location Address checks out

4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092
Phone: (770) 738-9657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT015913 (GA)

Record details

NPI number1093446221
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 20, 2022
Last updated in NPPESJune 20, 2022
Certification dateJune 15, 2022
Mailing address2381 Eastway Rd, Decatur, GA 30033-5543

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice Kime Performance Nevada Llc — 6 clinicians
Accepts Medicare assignment Not indicated

Other providers in Suwanee