Healthcare Provider Details

I. General information

NPI: 1700618782
Provider Name (Legal Business Name): AERIS PERFORMANCE CONCEPTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2024
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 ROSE DALE CT
PINEHURST NC
28374-6601
US

IV. Provider business mailing address

315 ROSE DALE CT
PINEHURST NC
28374-6601
US

V. Phone/Fax

Practice location:
  • Phone: 915-342-7113
  • Fax:
Mailing address:
  • Phone: 915-342-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT CHRISTOPHER DEMBOWSKI
Title or Position: DIRECTOR OF PHYSICAL THERAPY
Credential: PT, DSC, OCS, SCS
Phone: 915-342-7113