Provider Demographics
NPI:1598921496
Name:LINCK, GRAHAM MCALEER (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:GRAHAM
Middle Name:MCALEER
Last Name:LINCK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 E SAHARA AVE UNIT 139
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-6368
Mailing Address - Country:US
Mailing Address - Phone:702-533-8031
Mailing Address - Fax:
Practice Address - Street 1:750 CORONADO CENTER DR
Practice Address - Street 2:SUITE 140
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5034
Practice Address - Country:US
Practice Address - Phone:702-312-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2255225100000X
SD525207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36885Medicare PIN
NVAN716ZMedicare PIN