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For Fax/Mail Orders
LarreaRx
To: Boyce N. Berkel, MD
c/o Unique Enterprises
2330 Kings Point Drive
Largo, Florida
FAX: 888-268-2795
Email: painrlfctr@aol.com
For Fast
Secure Online Ordering Click Here!
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| Item# |
Product |
S/H |
Qty |
Price
Each |
Total
Cost |
| Best Value (6 mos) |
LarreaRx |
FREE |
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$219.97 |
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| 3 Month Special |
LarreaRx |
FREE |
|
$113.97 |
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| Starter Pack |
LarreaRx |
$4.97 |
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$37.97 |
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Total |
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| Name: |
| Address: |
| City: |
| State: |
Zip Code: |
Country: |
| Telephone Number: |
| Fax Number: |
| E-mail Address: |
| Payment Type |
Check |
Money Order |
Credit Card |
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| Exp. |
Visa |
M/C |
Discover |
Amex |
| Credit Card Number: |
| Shipping address if different from above: |
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