Register for Professional Pricing and Information about the ReBuilder

ReBuilder Medical Professional Program and Pricing Information Request

Please enter your clinical contact information and your NPI number.

We will verify your information and determine your individual pricing structure.

When completing the form, be sure to select your country first, to be able to select your state/province and enter your zip/postal code. (You can reset your password anytime after that.)

If you currently have an account with us, it is imperative that you place orders using the email we have on file so that you receive the correct discount. If you are unsure of the email for your account please call us at 877-717-5487. Click here to login.

In order for you to continue receiving your established professional discount, please do not start a new account. Placing an order under a new account may result in failure to apply your established discount rate. If this happens, inform us, we will issue a credit on your account.

If you have forgotten your password, click here.

Thank you.

Practice Name

First Name *

Last Name *

Country *

Address 1 *

Address 2

City *

State *

ZIP code *

Address *

Phone Number *

Email *

NPI Number *

If you have been referred by another physician, please enter their full name below.

Leave this field blank

Privacy notice: We will never sell or share any of your information.

Welcome Medical Professionals

Register below for pricing and information exclusive to medical practitioners.

ReBuilder Medical Professional Program and Pricing Information Request

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