Provider First Line Business Practice Location Address: 
57 DENNIS SANDLIN MD CV
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
HAZARD
    Provider Business Practice Location Address State Name: 
KY
    Provider Business Practice Location Address Postal Code: 
41701-1552
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
606-436-0686
    Provider Business Practice Location Address Fax Number: 
606-436-0547
    Provider Enumeration Date: 
12/18/2015