Healthcare Provider Details

I. General information

NPI: 1053232496
Provider Name (Legal Business Name): MERIDIAN THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 S ALASKA ST STE 1A
PALMER AK
99645-6338
US

IV. Provider business mailing address

4931 E MAYFLOWER LN STE 1
WASILLA AK
99654-7759
US

V. Phone/Fax

Practice location:
  • Phone: 907-746-7836
  • Fax:
Mailing address:
  • Phone: 907-746-7836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DYLAN DRAHOS
Title or Position: MANAGING MEMBER
Credential:
Phone: 907-746-7836