Provider Demographics
NPI:1851672539
Name:NICDAO, PLACIDO II (DC)
Entity Type:Individual
Prefix:DR
First Name:PLACIDO
Middle Name:
Last Name:NICDAO
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 CHALAN SAN ANTONIO
Mailing Address - Street 2:STE 101
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3644
Mailing Address - Country:US
Mailing Address - Phone:671-472-2225
Mailing Address - Fax:671-472-4476
Practice Address - Street 1:643 CHALAN SAN ANTONIO
Practice Address - Street 2:STE 101
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3644
Practice Address - Country:US
Practice Address - Phone:671-472-2225
Practice Address - Fax:671-472-4476
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008840111N00000X
GUC37111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor