Healthcare Provider Details

I. General information

NPI: 1912825852
Provider Name (Legal Business Name): HALLIE J FURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 GATEWAY RD STE 200
BROOKFIELD WI
53045-5115
US

IV. Provider business mailing address

8588 S 36TH ST
FRANKLIN WI
53132-9328
US

V. Phone/Fax

Practice location:
  • Phone: 414-964-4777
  • Fax:
Mailing address:
  • Phone: 832-870-0452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: