Provider Demographics
NPI:1275322547
Name:PODBIELSKI, MAKIAH
Entity type:Individual
Prefix:
First Name:MAKIAH
Middle Name:
Last Name:PODBIELSKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12260 HIGH VISTA DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-4400
Mailing Address - Country:US
Mailing Address - Phone:907-715-7620
Mailing Address - Fax:
Practice Address - Street 1:720 ROBB DR STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3733
Practice Address - Country:US
Practice Address - Phone:775-787-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1748225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant