Individual ProviderJustin Lee WilkeStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address507 N 17th St, Milwaukee, WI 53233(414) 288-5688PECOS EnrollmentBased on the most recent information from CMS, provider Justin Lee Wilke does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1609574276Provider TypeIndividualFull NameWilke, Justin LeeGenderMaleSole ProprietorYesEnumeration Date2/22/2023Last Updated2/22/2023Contact InformationPractice LocationPractice Address507 N 17th St, Milwaukee, WI 53233Phone(414) 288-5688FaxUnlisted FaxMailing LocationMailing Address507 N 17th St, Milwaukee, WI 53233PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer