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General NPI Number Information
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NPI Number | 1578480901
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Entity Type | Organization
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Legal Business Name | ANTIGRAVITY WELLNESS LLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 5219 W CLEARWATER AVE STE 12A
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City | KENNEWICK
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State | WA
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Zip | 99336-1980
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Country | US
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Telephone | 509-572-3304
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Fax | 509-206-8599
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Provider Business Mailing Address
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Address Line | 66603 E RANCH RD
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City | WEST RICHLAND
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State | WA
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Zip | 99353-9596
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Country | US
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Telephone | 509-820-0334
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Fax | 509-206-8599
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. NICOLE D SMITH
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Credential | DNP
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Telephone | 509-820-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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