MEDICARE: TC TIME ONE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1346178035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TC TIME ONE LLC

Provider Business Mailing Address
First Line	:	1300 PEACHTREE INDUSTRIAL BLVD STE 4108
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-4541
Country	:	US
Telephone Number	:	470-238-3683
Fax Number	:	470-238-3816

Provider Business Practice Location Address
First Line	:	1430 FIVE FORKS TRICKUM RD STE 210
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-8183
Country	:	US
Telephone Number	:	404-271-8432
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIEF CLINICAL DIRECTOR
Name	:	TONY CHUNG
Credential	:
Telephone Number	:	470-238-3683

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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