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Reseller / Professional Account

Welcome! You have chosen to set up a Reseller / Professional Account. This account will apply a reseller price for all items.

Pro Therapy Supplies will dropship at no extra charge. Please note there are additional discounts available for bulk orders.

If you have any questions, contact us at 1-800-883-0368.

Please fill out the information below. A representative will contact you within 24 to 48 hours to finalize your account.

Subject *

Full Name *

Email Address *

Phone Number *

Alt. Phone

Fax Number

Company Name

Website (Optional)

Main Address *

Address 2 (Optional)

Address 3 (Optional)

City *

State *

Zip Code *

Tax Exemption # (If Yes)

I am purchasing for *

Reseller: General

Reseller: International

Reseller: Retail Store

Reseller: Website Store

Reseller: Wholesale

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